Provider Demographics
NPI:1528269941
Name:LILES, LEIGH T (MD)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:T
Last Name:LILES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:
Other - Last Name:TRAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1801 PARGOUD BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-2532
Mailing Address - Country:US
Mailing Address - Phone:318-470-5727
Mailing Address - Fax:
Practice Address - Street 1:2104 LOOP RD STE A
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-3341
Practice Address - Country:US
Practice Address - Phone:318-435-6377
Practice Address - Fax:318-435-6378
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2022652084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry